If you or your loved one has been recently diagnosed with Mesothelioma, knowing what to expect can help you or the loved one cope. Just like many other cancers, a mesothelioma diagnosis can be scary. The more informed you are about the disease, the better.
Here, you will find every single thing you need to know about the disease. This includes what it really is, what causes it, its symptoms, diagnosis, treatment options, and prognosis.
What is Mesothelioma?
Mesothelioma is a rare and aggressive form of cancer that affects mesothelium, a protective lining/membrane that lines most internal organs of the body. The cancer primarily affects the lining of the lungs (pleural mesothelioma) or the abdomen (peritoneal mesothelioma), or the heart (pericardial mesothelioma). It can also affect the linings of the testicles.
According to various studies, 3 out of 4 cases of mesothelioma begin in pleural mesothelium in the chest cavity. This is to say that Pleural Mesothelioma is more prevalent among mesothelioma victims compared to other types of mesothelioma.
Regardless of where mesothelioma originates from, it can metastasize or spread to nearby body tissues and body parts quickly. Therefore, the earlier it’s detected, the better the prognosis. Although this is not always the case as your symptoms do not appear until it’s in the later/advanced stage.
“Approximately 2,000-3,000 people are diagnosed with mesothelioma every year in the United States.”
What Causes Mesothelioma?
Almost all cases of Mesothelioma are caused by prolonged exposure to asbestos.
Asbestos is a group of six types of naturally occurring minerals characterized by fine, microscopic fibers. The mineral was once referred to as the “miracle mineral” as the fibers have excellent resistance to fire, heat, chemicals, and do not conduct electricity. As a result, they were widely used in commercial, automotive, and construction industries.
When these microscopic fibers are inhaled or swallowed over time, they become lodged in the linings of the lungs, heart, and abdomen, causing a number of health complications. It usually takes a long period of time for the symptoms of asbestos-related diseases to appear. Mesothelioma takes 15-50 years for symptoms to develop after exposure.
Research indicates that approximately 75% of all mesothelioma cases are linked to prolonged exposure to asbestos at work. It was as a result referred to as “workers cancer.” Other studies have linked increased risk of mesothelioma and other asbestos-related diseases in immediate families and other people living with asbestos workers. Also, people living nearby asbestos mines have a higher risk of developing mesothelioma and other asbestos-related diseases.
In unique cases, some people who have been exposed to large amounts of asbestos do not get mesothelioma. Various studies have linked a person’s genes to reduced risk of developing mesothelioma. In other words, some people have genes that are resistant to the effects of asbestos to the body. Actually, in a recent study, researchers found that some people who are at a high risk have changes in BAP1, a certain gene that helps to keep cell growth under control.
Some studies have also found a strong link between radiation treatments for other forms of cancer and development of mesothelioma. Radiation causes damage to the cell structure (DNA), thus leading to abnormal cell growth.
The SV40 virus is also suspected to increase the risk of developing mesothelioma as researchers found it to have an effect on certain genes that have been linked with cancer. Since it has not yet been confirmed, more research is needed.
Types of Mesothelioma
Mesothelioma is categorized in two ways.
One, it’s categorized depending on where the cancer cells, tumors, are located in your body. In this category, there are four types of mesothelioma;
Pleural: Pleural mesothelioma usually affects the pleural lining of the lungs. It’s caused by the inhalation of the tiny asbestos fiber into the lungs. It’s the most common form of mesothelioma as it accounts for roughly 75% of all mesothelioma cases. It’s also one of the deadliest, is difficult to treat, and has a poor prognosis.
Peritoneal: Peritoneal mesothelioma affects the mesothelium lining of the abdomen. It’s caused by the ingestion of the microscopic asbestos fibers. This cancer accounts for approximately 20-25% of all mesothelioma cases.
Pericardial: Pericardial mesothelioma develops in the thin membranes surrounding the heart (pericardium). This form of mesothelioma is rare but deadly. As it progresses the heart is unable to pump oxygen to the body causing a person’s health to deteriorate at a very rapid rate.
Testicular: Testicular mesothelioma, also known as “tunica vaginalis testis,” is the rarest type of mesothelioma. This form of cancer affects the thin membrane lining that covers the testicles. It’s said to account for less than 1% of all mesothelioma cases. Most patients affected by this disease often have no history of asbestos exposure. Its prognosis is much better compared to other types of mesothelioma.
The other category classifies mesothelioma depending on the possible cell structure the cancer may have. They include;
Epithelioid: Epithelioid mesothelioma is a deadly form of mesothelioma that develops in healthy epithelial cells which mutate when exposed to asbestos. Unlike other types of mesothelioma cancers, it’s fairly difficult to treat and its prognosis is good.
Sarcomatoid: Sarcomatoid mesothelioma is the rarest but least treatable form of mesothelioma that affects the pleural membrane of the lungs. It’s commonly found in pleural mesothelioma patients. This cancer accounts for roughly 15% of all mesothelioma cases.
Biphasic: Biphasic mesothelioma is a form of mesothelioma that is a combination of both epithelial and sarcomatoid cells within the same tumor. It can be said to be a “mixed-type” mesothelioma. This cancer accounts for approximately 20-35% of all mesothelioma cases.
Doctors stage mesothelioma depending on the factors indicating its progression. The stages range from 1 to 4, and they help doctors to establish and classify the progression and severity of the cancer. Stage 1 is the most treatable while stage 4 providers the fewest treatment options. Stage 4 is restricted to palliative care.
To determine the stage of the cancer, doctors perform different tests by examining patients using CT scans, X-rays as well as other diagnostic techniques.
The characteristics of the four stages differ slightly.
Stage I: The tumor is in one location. The cancer cells have not spread to the lymph nodes or any other tissue or organ. Surgery can be used in the treatment of patients in this stage.
Stage II: The tumor is a bit larger and has attacked nearby tissues or organs, for example the diaphragm or lung. Lymph nodes may be involved too and surgical removal may still be an option. However, the procedure may be more difficult than in stage 1.
Stage III: This stage is characterized by the invasion of an area or region, for instance the esophagus, lymph nodes or chest wall. Generally, surgery is not an option but other treatment options may be used.
Stage IV: This stage is characterized with the spread of cancer to a number of areas including other tissues and organs throughout the body. Treatment in this stage focuses on reducing discomfort and pain.
Prognosis for Stage 4 is usually very poor. Various treatment options such as chemotherapy, radiation, and palliative treatments are often used. Alternative treatments at this stage are incorporated to improve the life quality of the patient and to extend their lifespan.
The symptoms and signs of mesothelioma differ depending on the location of the cancer in the body.
1). Pleural Mesothelioma Symptoms
Because it affects the lungs, pleural mesothelioma often affects your breathing (you may have some difficulties breathing) and the chest (thoracic cavity).
Its symptoms often manifest themselves when the cancer has very much advanced, usually in stage 4. Its symptoms include;
- Pleural effusion (buildup of fluid in the lining of your lungs)
- Shortness of breath/difficulty breathing
- Sudden or unexplained weight loss
- Chest pain and general body aches
- Chronic coughing
- Fever and night sweats
- Chronic fatigue
2). Peritoneal Mesothelioma Symptoms
Just like pleural mesothelioma, the symptoms of peritoneal mesothelioma usually occur after the cancer has largely affected your abdomen and the surrounding organs. This is usually in Stage 3 and 4. You may experience symptoms of peritoneal mesothelioma include;
- Ascites (build-up of fluid in the abdomen)
- Persistent and severe abdominal pain
- Abnormal abdominal swelling
- Unexplained or sudden weight loss
- Anemia- often in women
- Loss of appetite
- Bowel obstruction
3). Pericardial Mesothelioma Symptoms
Pericardial mesothelioma is rare and deadly as it’s not often diagnosed until the patients dies. It’s often difficult to identify its symptoms as the disease often mimics other heart-related conditions such as heart failure, coronary heart disease, and pericarditis.
Its symptoms include;
- Pericardial effusion (buildup of fluid between the pericardium membrane and the heart)
- Arrhythmia (irregular heartbeat or palpitations)
- Shortness of breath (dyspnea)
- Fever and night sweats
- Severe chest pain
- Heart murmur
4). Testicular Mesothelioma Symptoms
Testicular mesothelioma is often misdiagnosed because of its rarity and may be confused with hernia, which is a common condition. Accurate diagnosis is often made during surgery. The most common symptoms of testicular mesothelioma include;
- Hydrocele (build-up of fluid in the scrotum)
- Pain and swelling in the testicles
- Abnormal lump inside the scrotum
Because mesothelioma is often misdiagnosed, typically, physicians will try to diagnose the cancer by eliminating other potential or related complications. This often involves performing a number of tests that provide different types of information. These tests usually help doctors diagnose mesothelioma and check how far it has spread.
Common tests used to diagnose the different types of mesothelioma include;
Imaging Tests: These include X-rays, CT Scans, PET scans, and MRI scans. These tests are non-invasive and are usually very important when it comes to detecting mesothelioma.
Blood Tests: Doctors may perform certain blood tests to detect mesothelioma in the lungs, abdomen, and heart. Some common blood tests used to diagnose the disease include mesomark and somamer.
Biopsies: Biopsies are performed through processes such as thoracoscopy or laparoscopy. A tissue sample is removed and analyzed to detect the presence of mesothelioma cells.
Fluid Drainage: If there is fluid buildup in the lungs or abdomen, a sample may be removed for analyzation.
Mesothelioma Life Expectancy
Mesothelioma is a type of cancer whose signs and symptoms usually only show up in later stages. Lasting survival is exceedingly rare, with less than 10 percent of patients having a life expectancy of more than 5 years. As such, life expectancy for the patients is usually short, particularly without treatment.
Mesothelioma patients usually have a life expectancy of between 12 and 21 months. However, the length of a patient’s life depends on numerous factors including the stage of mesothelioma, age, sex, quality of health care and general health.
Stage: Life expectancy may improve significantly if the disease is diagnosed at early stages especially stage I or stage II as there is minimal or no spreading. As such, treatments are very likely to be effective. However, in later stages, the mesothelioma has advanced beyond the original location, making treatment quite difficult.
Location: The location where the mesothelioma develops may also affect life expectancy. Patients with pericardial mesothelioma have a shorter life expectancy when compared to the patients suffering from peritoneal mesothelioma or pleural mesothelioma.
Patient Age: A patient age is also key in determining the life expectancy of a mesothelioma patient. Overall, older patients have a shorter life expectancy, especially because of a poorer overall health.
Cell Type: The mesothelioma cell type of a patient affects the life expectancy of a patient. There are three different mesothelioma cell types: sarcomatoid, epithelioid and biphasic. Normally, patients with sarcomatoid mesothelioma have a considerably shorter life expectancy than the patients with epithelioid mesothelioma. On the other hand, patients with biphasic mesothelioma cells have an in-between life expectancy.
Gender: Generally, more men than women have mesothelioma, mostly because of occupational differences as well as the risk of asbestos exposure. In general, women patients tend to have a longer life expectancy than men. On average, female patients live 5.5 months longer than male patients.